Background

Metabolic and bariatric surgery is a safe and effective treatment strategy for severe childhood obesity, affecting 10% of U.S. adolescents. This prospective observational study addresses knowledge gaps related to changes in weight, cardiometabolic risk, and weight-related quality of life (WRQOL) in adolescents 10 years after laparoscopic adjustable gastric band (LAGB) insertion.

Methods

Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) collected anthropometric, micronutrient, cardiometabolic risk and WRQOL data on 274 adolescents, of which 14 participants underwent LAGB insertion between 2007-2012. Descriptive analyses compared outcomes at baseline and 10 years.

Results

Participants were mostly female (86%), white (71%), with a median age of 18.5 years and preoperative median body mass index (BMI) of 49 kg/m2. Baseline prevalence of type 2 diabetes, hypertension, and dyslipidemia among initial 14 LAGB participants were 1/14 (7%), 8/14 (57%), and 8/13 (62%), respectively, compared to 10-year prevalence of 1/8 (13%), 4/10 (40%), and 3/9 (33%), respectively. Two participants underwent LAGB removal (Years 2 and 3); two others converted to RYGB (Years 2 and 6). Following initial BMI reduction (-10%) at Year 1 (Figure), 10-year median BMI for the total cohort was 48 kg/m2 compared to 51 kg/m2 (5% versus 9% increase) for 10 participants who retained their LAGB throughout the study. Micronutrient abnormalities and WRQOL remained similar between baseline and 10 years.

Conclusions

Long-term follow-up of this cohort reveals that LAGB has minimal impact on change in BMI, cardiometabolic risk factors, and WRQOL among adolescents. These results confirm the limited efficacy of LAGB in the pediatric population.